Training Tomorrow Research Articles

Damaged cars find a new use in training tomorrow’s technicians

Damaged cars find a new use in training tomorrow’s technicians

Training tomorrow’s public health leaders

Training tomorrow’s public health leaders

Training tomorrow's public health leaders

Training tomorrow's public health leaders

Training tomorrow's doctors in diabetes: self-reported confidence levels, practice and perceived training needs of post-graduate trainee doctors in the UK. A multi-centre survey

ObjectiveTo assess the confidence, practices and perceived training needs in diabetes care of post-graduate trainee doctors in the UK.MethodsAn anonymised postal questionnaire using a validated 'Confidence Rating' (CR) scale was applied to aspects of diabetes care and administered to junior doctors from three UK hospitals. The frequency of aspects of day-to-day practice was assessed using a five-point scale with narrative description in combination with numeric values. Respondents had a choice of 'always' (100%), 'almost always' (80–99%), 'often' (50–79%), 'not very often' (20–49%) and 'rarely' (less than 20%). Yes/No questions were used to assess perception of further training requirements. Additional 'free-text' comments were also sought.Results82 doctors completed the survey. The mean number of years since medical qualification was 3 years and 4 months, (range: 4 months to 14 years and 1 month). Only 11 of the respondents had undergone specific diabetes training since qualification.4(5%) reported 'not confident' (CR1), 30 (37%) 'satisfactory but lacked confidence' (CR2), 25 (30%) felt 'confident in some cases' (CR3) and 23 (28%) doctors felt fully confident (CR4) in diagnosing diabetes. 12 (15%) doctors would always, 24 (29%) almost always, 20 (24%) often, 22 (27%) not very often and 4 (5%) rarely take the initiative to optimise gcaemic control. 5 (6%) reported training in diagnosis of diabetes was adequate while 59 (72%) would welcome more training. Reported confidence was better in managing diabetes emergencies, with 4 (5%) not confident in managing hypoglycaemia, 10 (12%) lacking confidence, 22 (27%) confident in some cases and 45 (55%) fully confident in almost all cases. Managing diabetic ketoacidosis, 5 (6%) doctors did not feel confident, 16 (20%) lacked confidence, 20 (24%) confident in some cases, and 40 (50%) felt fully confident in almost all cases.ConclusionThere is a lack of confidence in managing aspects of diabetes care, including the management of diabetes emergencies, amongst postgraduate trainee doctors with a perceived need for more training. This may have considerable significance and further research is required to identify the causes of deficiencies identified in this study.

Training Tomorrow's Television Journalists: In the Trenches with Media Convergence

The researchers conducted a nationwide survey examining the impact of convergence on reporters and producers in small and medium-sized local television markets. We examined the practices of news workers in television media markets 51 and below—markets in which journalism students usually obtain their first jobs. Data revealed nearly 70% of respondents personally performed convergent tasks, and we found significant differences between reporters and producers regarding the convergent activities to which they're tasked. Findings are interpreted in light of training expectations for educators and news managers.

Promoting skill-building in cultural competence: A must for paediatricians who care for socially vulnerable populations

The demographics of Canadian society have evolved significantly over the past 40 years. The switch in immigration policy from a geopolitical quota-based system to a points-based system of immigration in the mid-1960s has contributed to an unprecedented cultural and ethnic diversity in this country. There is increasing recognition among health science educators that there is a specific skill set that tomorrow’s (and today’s) health care professionals will require to practice effectively in this exciting new reality. Canada’s largest city, Toronto, Ontario, is second in the world after Miami (USA) in having the largest number of foreign-born residents on earth (43.7% at the 2001 census; the geographical origins of Toronto’s foreign-born are much more diverse than in Miami) (1). Immigration has contributed to the significant cultural diversity that exists in all major urban centres in Canada, and newly arrived Canadians are often faced with downward mobility that increases the risk of marginalization through poverty (30% of immigrants versus 21.6% of all Canadians were living below the poverty line in 1995) (2). Canada’s First Nations peoples represent another important, culturally diverse and severely marginalized population. Significant and discouraging health status disparities are well-documented among these diverse cultural groups (reviewed and referenced below). These populations are not only affected by geographical isolation, but also by chronic poverty, under- or unemployment, substance use and abuse, and limited opportunities for education and social advancement (to give but a few examples of observed social determinants of health among Aboriginal populations in Canada) (3). It is, thus, important to recognize that the efficacious medical practitioner who cares for populations that are socially vulnerable and marginalized by poverty needs competence in caring for patients from a diverse set of backgrounds, including cultural and socioeconomic diversity. As paediatricians, we have long recognized that children fundamentally exist within the context of a family and a community, and that practicing effectively in the care of children means incorporating these realities into therapeutic decision-making. If we are to train tomorrow’s paediatricians to care and advocate for Canada’s most vulnerable children and to view working toward eliminating health care delivery biases as a part of the social accountability of the profession, we will need to promote the development of skills in negotiating culture in the clinical encounter, as well as an understanding of broader issues, such as discrimination and bias, in the way health care is experienced by marginalized populations such as our oldest (First Nations) and newest (recently arrived Canadians) cultural groups.

A NEW SURGICAL EDUCATION AND TRAINING PROGRAMME

Educating and training tomorrow's surgeons has evolved to become a sophisticated and expensive exercise involving a wide range of learning methods, opportunities and stakeholders. Several factors influence this process, prompting those who provide such programmes to identify these important considerations and develop and implement appropriate responses. The Royal Australasian College of Surgeons embarked on this course of action in 2005, the outcome of which is the new Surgical Education and Training programme with the first intake to be selected in 2007 and commence training in 2008. The new programme is competency based and shorter than any designed previously. Implicitly, it recognizes in the curriculum and assessment development and processes, the nine roles and their underpinning competencies identified as essential for a surgeon. It is an evolution of the previous programme retaining that which has been found to be satisfactory. There will be one episode of selection directly into the candidate's specialty of choice and those accepted will progress in an integrated and seamless fashion, provided they meet the clinical and educational requirements of each year. The curriculum and assessment in the basic sciences include both generic and specially aligned components from the commencement of training in each of the nine surgical specialties. Born of necessity and developed through extensive research, discussion and consensus, the implementation of this programme will involve many challenges, particularly during the transition period. Through cooperation, commitment and partnerships, a more efficient and better outcome will be achieved for trainees, their trainers and their patients.

Training tomorrow's surgeons

Jackson and Gibbin1 point out that one of the fundamental problems faced by today's surgical trainees is decreased operative exposure. This is a result of a combination of reduced working hours due to the European Working Time Directive, and shortened surgical training. In addition, there has been much debate over the medico-legal and ethical issues regarding consent, where trainees practice on real patients under the supervision of surgical tutors.2,3 The traditional assessment of direct observation of trainee performance is often influenced by subjectivity, since different trainers have different expectations, and the use of a logbook only demonstrates individual trainee operative exposure and not competency. The accuracy of these logbooks are also often questionable as they rely heavily on self-assessment, and hence tend to lack reliability and validity.4 We therefore agree with the authors that we have much to learn from the aviation industry, especially regarding the use of virtual reality simulators. Virtual reality simulators allow automated objective measurements and assessment of surgical skills, which were not previously possible. It also allows new surgical trainees to be trained in their own time without endangering patient lives, and for some simulators, the predictive validity of skills transfer to real operations has been proven. Although this type of training is still in its infancy, we can anticipate that virtual reality simulators will be a great asset to the surgical training curriculum, both as means of training, as well as an assessment tool.

Training tomorrow's surgeons

Jackson and Gibbin1 point out that one of the fundamental problems faced by today's surgical trainees is decreased operative exposure. This is a result of a combination of reduced working hours due to the European Working Time Directive, and shortened surgical training. In addition, there has been much debate over the medico-legal and ethical issues regarding consent, where trainees practice on real patients under the supervision of surgical tutors.2,3 The traditional assessment of direct observation of trainee performance is often influenced by subjectivity, since different trainers have different expectations, and the use of a logbook only demonstrates individual trainee operative exposure and not competency. The accuracy of these logbooks are also often questionable as they rely heavily on self-assessment, and hence tend to lack reliability and validity.4 We therefore agree with the authors that we have much to learn from the aviation industry, especially regarding the use of virtual reality simulators. Virtual reality simulators allow automated objective measurements and assessment of surgical skills, which were not previously possible. It also allows new surgical trainees to be trained in their own time without endangering patient lives, and for some simulators, the predictive validity of skills transfer to real operations has been proven. Although this type of training is still in its infancy, we can anticipate that virtual reality simulators will be a great asset to the surgical training curriculum, both as means of training, as well as an assessment tool.

The Developing Specialty of Hand Surgery: Training tomorrow's hand surgeons

The Developing Specialty of Hand Surgery: Training tomorrow's hand surgeons

Training tomorrow's teachers today: a national medical student teaching and leadership retreat

Introduction: Challenges to American academic medical centers have diverted attention and resources away from the core missions of teacher and leader development. To train the next generation of medical education leaders, substantial and institutionalized new programs are necessary.Methods: The American Medical Student Association, with the Mount Sinai School of Medicine, designed the Training Tomorrow's Teachers Today national medical student retreat. The week-long course endeavors to enhance participants’ clinical teaching and academic leadership skills. The program also trains students to execute a required medical education project. At the end of the course, attendees evaluated their baseline and post-course teaching and leadership effectiveness. Long-term follow-up was also completed.Results: Attendees (n = 23) self-reported statistically significant (p < 0.05) improvement in teaching and leadership. The greatest improvements in teaching scores were in the area of communicating goals. The largest leadership score improvements were: defining goals; defining constituents, allies, and opponents; and delineating organization strengths/weaknesses. 13 participants engaged in medical education projects.Conclusion: This program helps fill a gap in medical education training. Program data suggest enhancement of students’ teaching and leadership skills. A competitive application process demonstrates interest in such training. These results suggest that medical schools should offer and/or fund undergraduate teaching and leadership training.

Ethical dilemmas in training tomorrow's doctors

This article describes some of the challenges that face trainers and trainees in medical education. There are ethical issues surrounding the use of real patients - particularly children and young people. How much can a young trainee "practise" on a patient? How can they best learn practical skills or gain experience of intimate examinations? The requirements of professional behaviour of trainers towards trainees and of both towards patients are described. Patients involvement in teaching, assessment and formal examinations is discussed.

Clinical research career development: the individual perspective.

The process of integrating medical scientific breakthroughs into improved clinical practice requires talented and dedicated clinical investigators. Unfortunately, substantial impediments deter gifted physicians from clinical research. The experience of "Dr. Ross," an aspiring (fictional) clinical investigator, is presented in this report. The factors that ultimately contribute to Dr. Ross' choice to abandon an academic clinical research career are explored. Issues relating to research training, mentoring, funding, and academic promotion standards are analyzed from his individual perspective. Special emphasis is given to the intense financial pressure trainees face. Finally, potential solutions are presented. These include a description of the National Institutes of Health K23, K24, and K30 programs and its new extramural Loan Repayment Program for clinical researchers. These important advances provide much-needed support, but additional work must be done. In the absence of further reform, academic medicine's mission to train tomorrow's clinical investigators will erode further.

Does Switzerland train tomorrow's surgeons today? Today's reflections on tomorrow's surgeons.

Various factors are influencing the Swiss health care system, and therefore, surgeons' actual and future profession. Initiated by the current president of the Swiss Society of Surgery, a group of eight young Swiss surgeons constituted the ad hoc committee "Chirurgie 2020". The goal was to develop several scenarios of the surgeon's professional situation in 20 years. The future direction of surgery will be markedly influenced by medical innovation, political and economic relationships between Switzerland and Europe. However, the development of health care costs represents the most powerful factor predicting all further changes. The current situation of today's surgeons is best characterised as "hamsters in the treadmill" who try to fulfill a multitude of diverging tasks causing major demotivation. In order to retain a leading role in the health care system, surgeons must take part in social and political activities. To provide an excellent curriculum, university and county hospitals must join together to form clinical and educational networks. A clearly defined and structured curriculum must be introduced by the Swiss Society of Surgery. From our current point of view, only everyone's strong personal commitment will help to find solutions and to improve the current and future situation. In particular, today's surgical residents must actively take part in the development of tomorrow's surgery.

ERIC Review: The Role of Community Colleges in Training Tomorrow's School Teachers

This review of the literature focuses on the need for teachers and how community colleges are presenting themselves as a source for teacher recruitment. After describing the need for teachers in different contexts, the author explores why students enter teaching careers, how community colleges are a recruitment source, and how community colleges educate prospective teachers. The author then illustrates the community college's role in teacher training with three examples of training programs. The review concludes with goals for the future such as expanding articulation agreements and partnerships with four-year colleges, offering counseling and student support services, and involving students in local schools.

Training Tomorrow's Leaders: Enhancing the Emotional Intelligence of Business Graduates

Educational institutions have traditionally focused primarily on the importance of IQ with less attention given to other types of intelligence. Yet many reserchers are begining to argue that intrapersonal and interpersonal competencies, or emotional intelligence, may be more important for success in life than IQ. It is important, then, for business schools to consider ways to incorporare emotional intelligence skills into each student's “toolbox” for enhanced career success. This article reviews the developing literature on emotional intelligence and discusses a model for incorporating emotional intelligence into the curriculum through the use of assessment tools and experiential exercises.

Cyberspace in the Curricula: New Legal and Ethical Issues

Journalism and mass communication programs have been forced to take long, hard looks at their curricula as they join the media industry in eyeing the encroachment of interactive media technology (Yavovich, 1996). The newspaper industry has embraced electronic publishing with a fervor that has made the establishment of on-line editions almost a necessity, evidenced by the fact that 1,600 daily and weekly newspapers had launched on-line publishing endeavors by the end of 1996 (Levins, 1997). Advertising agencies and public relations firms have enthusiastically eyed the Internet's new marketing and promotional possibilities among a psychographically unique, computer-oriented consumer culture (Dorf, 1995; Worthington, 1995). Broadcasters and cable networks have launched on-line endeavors that are currently mostly promotional in nature, but some companies, such as the Discovery Channel, have introduced innovative information services to compliment their telecasts, and other channels at both the network and local market level are forecasted to follow this trend (Bates et al., 1997; Tedesco, 1996). Educators have responded to the hoopla surrounding cyberspace with the realization that some degree of exposure to interactive media is an important component in training tomorrow's media professionals. Computer assisted reporting classes have been established to teach students the art of using electronic data bases as tools of information retrieval (Lee & Fleming, 1995). Moreover, as interactive media have somewhat blurred the distinctions between the various disciplines, many schools have also begun to incorporate web page design and multimedia production into advertising, public relations and broadcasting courses (Friedland & Webb, 1996; Thompson, 1995). Clearly, the abyss of cyberspace and interactive media has challenged the imagination - and, to a degree, the resources - of journalism schools as educators timidly join the business sector in anticipating the future possibilities of this new medium. But as this industry-induced vacuum pulls educators in the direction of interactive media technologies, critics sound a note of caution. The new media, they say, were born into a world more concerned with gadgetry than substance, just as radio and television were first introduced as technological achievements earlier this century, with little thought devoted to their actual use. As Everette Dennis (1995) writes: While the new electronic media have many value-added elements, from speed of delivery of information to convenient electronic editing, it is clear that those who manufacture equipment and engineer software have not been overly concerned with stimulating public discourse or affecting the conduct of public affairs. Although they do see information delivery as a major function of online services... (they) have been more concerned with process than with content (p. 1). The growing popularity of the World Wide Web has created an atmosphere where, as columnist Mark Fitzgerald (1995, p. 34) observes,anyone-or any business - can be a publisher of something that at least looks like a newspaper. And while the new media forms fostered by interactive computer technology bear some resemblance to more traditional prototypes, the peculiarities associated with cyberspace -the anonymity of its users, the ease with which sensitive information can be accessed, and the complexities involved in creating meaningful regulation-have bred complex new twists to old legal and ethical problems, and those complications seem to defy the parameters of accountability that have traditionally governed print and broadcasting. In the words of legal specialist Margaret Blair Soyster (1996), Media law has not kept pace with on-line technology, leaving newspapers and their lawyers scrambling to devise practices that will stand them in good stead when legal challenges arise (p. 281). These complexities shroud the reputation of the Internet at a crucial juncture in its development as a communications medium. …

Training Tomorrow's Integrators in Today's Busy Intersection: Better Look Four Ways before Crossing

As the modern integration movement continues to mature, three factors seem crucial to future training efforts. At the same time that third party control (managed care) and a burgeoning interest in spirituality (third party presence) are sending shock waves through the profession of applied psychology, leaders in the integration field are announcing an evolution of focus toward more practical and personal integration. These converging themes cast long implications across the construction of training programs which will spawn a new generation of integrators. In this article I discuss trends in training and suggest that future instructional efforts should be informed by four views: Out (practical integration), In (personal integration), Back (classic integration/soul care), and Forward (contemporary integration). I present and critique the Institute of Clinical Theology, an existing educational model based on these four views, and conclude with 12 training goals.

The need for comprehensive data on educational affiliations between academic health centers and managed care organizations.

Because of the emerging dominance of managed care, it is important to encourage the development of partnerships and affiliations between academic health centers (AHCs) and managed care organizations (MCOs) to train tomorrow's physicians to operate effectively in the new health care environment. But to what extent do such relationships exist now. In 1996, the authors sought to identify existing databases on the availability and extent of existing education partnerships and affiliations between AHCs and MCOs and the availability of such information to policymakers, the educational community, students, and residents. Despite a thorough search of the literature and interviews with representatives of education and practice organizations and with other experts in the medical education and managed care fields, the authors found no centralized or even partly centralized database on opportunities for training in managed care settings or on AHC-MCO partnerships. However, anecdotal evidence revealed eight such partnerships, each different from the others, that can serve as models for future partnerships; these are described. The authors speculate about why there are not more data describing AHC-MCO partnerships. They conclude by stating that the health care and health education industries have a variety of professional associations that could work together to assemble and make available such data to help build the educational and information infrastructure needed to train future physicians.

Training Tomorrow′s PLA: A Mixed Bag of Tricks

Since the summer of 1995, Chinese military training opposite Taiwan has received unusual prominence in both the Chinese and foreign media. The senior leadership in Beijing was able to flex its military muscle because of a training programme begun years ago. This limited use of force has sent unmistakable political signals to Taiwan and the world. But, should the Chinese leadership decide to employ the People′s Liberation Army (PLA) in pursuit of its political objectives, is it well trained enough to conduct successful modern military operations?